PittsburghV1, Main, Exploration, bibRecord, 001280

Sleep Architecture Following a Weight Loss Intervention in Overweight and Obese Patients with Obstructive Sleep Apnea and Type 2 Diabetes: Relationship to Apnea-Hypopnea Index

Identifieur interne : 001280 ( Main/Exploration ); précédent : 001279; suivant : 001281

Sleep Architecture Following a Weight Loss Intervention in Overweight and Obese Patients with Obstructive Sleep Apnea and Type 2 Diabetes: Relationship to Apnea-Hypopnea Index

Auteurs : Ari Shechter [États-Unis] ; Marie-Pierre St-Onge [États-Unis] ; Samuel T. Kuna [États-Unis] ; Gary Zammit [États-Unis] ; Arindam Roychoudhury [États-Unis] ; Anne B. Newman [États-Unis] ; Richard P. Millman [États-Unis] ; David M. Reboussin [États-Unis] ; Thomas A. Wadden [États-Unis] ; John M. Jakicic [États-Unis] ; F. Xavier Pi-Sunyer [États-Unis] ; Rena R. Wing [États-Unis] ; Gary D. Foster [États-Unis]

Source :

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine [ 1550-9389 ] ; 2014.

RBID : PMC:4224721

Descripteurs français

English descriptors

KwdEn :
- Adult, Aged, Anthropometry, Apnea (epidemiology), Apnea (physiopathology), Body Mass Index, Diabetes Mellitus, Type 2 (diagnosis), Diabetes Mellitus, Type 2 (epidemiology), Diabetes Mellitus, Type 2 (therapy), Diet, Reducing, Female, Follow-Up Studies, Humans, Life Style, Linear Models, Male, Middle Aged, Obesity (diagnosis), Obesity (epidemiology), Obesity (therapy), Overweight (diagnosis), Overweight (epidemiology), Overweight (therapy), Patient Education as Topic (methods), Polysomnography (methods), Predictive Value of Tests, Reference Values, Risk Assessment, Risk Reduction Behavior, Sleep (physiology), Sleep Apnea, Obstructive (diagnosis), Sleep Apnea, Obstructive (epidemiology), Sleep Apnea, Obstructive (physiopathology), Sleep Apnea, Obstructive (therapy), Sleep Stages (physiology), Sleep, REM (physiology), Treatment Outcome, Weight Loss (physiology).
MESH :
- diagnosis : Diabetes Mellitus, Type 2, Obesity, Overweight, Sleep Apnea, Obstructive.
- epidemiology : Apnea, Diabetes Mellitus, Type 2, Obesity, Overweight, Sleep Apnea, Obstructive.
- methods : Patient Education as Topic, Polysomnography.
- physiology : Sleep, Sleep Stages, Sleep, REM, Weight Loss.
- physiopathology : Apnea, Sleep Apnea, Obstructive.
- therapy : Diabetes Mellitus, Type 2, Obesity, Overweight, Sleep Apnea, Obstructive.
- Adult, Aged, Anthropometry, Body Mass Index, Diet, Reducing, Female, Follow-Up Studies, Humans, Life Style, Linear Models, Male, Middle Aged, Predictive Value of Tests, Reference Values, Risk Assessment, Risk Reduction Behavior, Treatment Outcome.

Abstract

Study Objectives:

To determine if weight loss and/or changes in apnea-hypopnea index (AHI) improve sleep architecture in overweight/obese adults with type 2 diabetes (T2D) and obstructive sleep apnea (OSA).

Methods:

This was a randomized controlled trial including 264 overweight/obese adults with T2D and OSA. Participants were randomized to an intensive lifestyle intervention (ILI) or a diabetes and support education (DSE) control group. Measures included anthropometry, AHI, and sleep at baseline and year-1, year-2, and year-4 follow-ups.

Results:

Changes in sleep duration (total sleep time [TST]), continuity [wake after sleep onset (WASO)], and architecture stage 1, stage 2, slow wave sleep, and REM sleep) from baseline to year 1, 2, and 4 did not differ between ILI and DSE. Repeated-measure mixed-model analyses including data from baseline through year-4 for all participants demonstrated a significant positive association between AHI and stage 1 sleep (p < 0.001), and a significant negative association between AHI and stage 2 (p = 0.01) and REM sleep (p < 0.001), whereas changes in body weight had no relation to any sleep stages or TST. WASO had a significant positive association with change in body weight (p = 0.009).

Conclusions:

Compared to control, the ILI did not induce significant changes in sleep across the 4-year follow-up. In participants overall, reduced AHI in overweight/obese adults with T2D and OSA was associated with decreased stage 1, and increased stage 2 and REM sleep. These sleep architecture changes are more strongly related to reductions in AHI than body weight, whereas WASO may be more influenced by weight than AHI.

Clinical Trial Registration:

ClinicalTrials.gov identifier: NCT00194259

Citation:

Shechter A, St-Onge MP, Kuna ST, Zammit G, RoyChoudhury A, Newman AB, Millman RP, Reboussin DM, Wadden TA, Jakicic JM, Pi-Sunyer FX, Wing RR, Foster GD, Sleep AHEAD Research Group of the Look AHEAD Research Group. Sleep architecture following a weight loss intervention in overweight and obese patients with obstructive sleep apnea and type 2 diabetes: relationship to apnea-hypopnea index. J Clin Sleep Med 2014;10(11):1205-1211.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4224721

DOI: 10.5664/jcsm.4202
PubMed: 25325608
PubMed Central: 4224721

Affiliations:

Le document en format XML

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<term>Aged</term>
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<term>Apnea (epidemiology)</term>
<term>Apnea (physiopathology)</term>
<term>Body Mass Index</term>
<term>Diabetes Mellitus, Type 2 (diagnosis)</term>
<term>Diabetes Mellitus, Type 2 (epidemiology)</term>
<term>Diabetes Mellitus, Type 2 (therapy)</term>
<term>Diet, Reducing</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Life Style</term>
<term>Linear Models</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Obesity (diagnosis)</term>
<term>Obesity (epidemiology)</term>
<term>Obesity (therapy)</term>
<term>Overweight (diagnosis)</term>
<term>Overweight (epidemiology)</term>
<term>Overweight (therapy)</term>
<term>Patient Education as Topic (methods)</term>
<term>Polysomnography (methods)</term>
<term>Predictive Value of Tests</term>
<term>Reference Values</term>
<term>Risk Assessment</term>
<term>Risk Reduction Behavior</term>
<term>Sleep (physiology)</term>
<term>Sleep Apnea, Obstructive (diagnosis)</term>
<term>Sleep Apnea, Obstructive (epidemiology)</term>
<term>Sleep Apnea, Obstructive (physiopathology)</term>
<term>Sleep Apnea, Obstructive (therapy)</term>
<term>Sleep Stages (physiology)</term>
<term>Sleep, REM (physiology)</term>
<term>Treatment Outcome</term>
<term>Weight Loss (physiology)</term>
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<term>Adulte d'âge moyen</term>
<term>Anthropométrie</term>
<term>Apnée (physiopathologie)</term>
<term>Apnée (épidémiologie)</term>
<term>Comportement de réduction des risques</term>
<term>Diabète de type 2 ()</term>
<term>Diabète de type 2 (diagnostic)</term>
<term>Diabète de type 2 (épidémiologie)</term>
<term>Femelle</term>
<term>Humains</term>
<term>Indice de masse corporelle</term>
<term>Mode de vie</term>
<term>Modèles linéaires</term>
<term>Mâle</term>
<term>Obésité ()</term>
<term>Obésité (diagnostic)</term>
<term>Obésité (épidémiologie)</term>
<term>Perte de poids (physiologie)</term>
<term>Phases du sommeil (physiologie)</term>
<term>Polysomnographie ()</term>
<term>Régime amaigrissant</term>
<term>Résultat thérapeutique</term>
<term>Sommeil (physiologie)</term>
<term>Sommeil paradoxal (physiologie)</term>
<term>Sujet âgé</term>
<term>Surpoids ()</term>
<term>Surpoids (diagnostic)</term>
<term>Surpoids (épidémiologie)</term>
<term>Syndrome d'apnées obstructives du sommeil ()</term>
<term>Syndrome d'apnées obstructives du sommeil (diagnostic)</term>
<term>Syndrome d'apnées obstructives du sommeil (physiopathologie)</term>
<term>Syndrome d'apnées obstructives du sommeil (épidémiologie)</term>
<term>Valeur prédictive des tests</term>
<term>Valeurs de référence</term>
<term>Éducation du patient comme sujet ()</term>
<term>Études de suivi</term>
<term>Évaluation des risques</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Diabetes Mellitus, Type 2</term>
<term>Obesity</term>
<term>Overweight</term>
<term>Sleep Apnea, Obstructive</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Diabète de type 2</term>
<term>Obésité</term>
<term>Surpoids</term>
<term>Syndrome d'apnées obstructives du sommeil</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Apnea</term>
<term>Diabetes Mellitus, Type 2</term>
<term>Obesity</term>
<term>Overweight</term>
<term>Sleep Apnea, Obstructive</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Patient Education as Topic</term>
<term>Polysomnography</term>
</keywords>
<keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Perte de poids</term>
<term>Phases du sommeil</term>
<term>Sommeil</term>
<term>Sommeil paradoxal</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Sleep</term>
<term>Sleep Stages</term>
<term>Sleep, REM</term>
<term>Weight Loss</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Apnée</term>
<term>Syndrome d'apnées obstructives du sommeil</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Apnea</term>
<term>Sleep Apnea, Obstructive</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Diabetes Mellitus, Type 2</term>
<term>Obesity</term>
<term>Overweight</term>
<term>Sleep Apnea, Obstructive</term>
</keywords>
<keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Apnée</term>
<term>Diabète de type 2</term>
<term>Obésité</term>
<term>Surpoids</term>
<term>Syndrome d'apnées obstructives du sommeil</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Anthropometry</term>
<term>Body Mass Index</term>
<term>Diet, Reducing</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Life Style</term>
<term>Linear Models</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Predictive Value of Tests</term>
<term>Reference Values</term>
<term>Risk Assessment</term>
<term>Risk Reduction Behavior</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Anthropométrie</term>
<term>Comportement de réduction des risques</term>
<term>Diabète de type 2</term>
<term>Femelle</term>
<term>Humains</term>
<term>Indice de masse corporelle</term>
<term>Mode de vie</term>
<term>Modèles linéaires</term>
<term>Mâle</term>
<term>Obésité</term>
<term>Polysomnographie</term>
<term>Régime amaigrissant</term>
<term>Résultat thérapeutique</term>
<term>Sujet âgé</term>
<term>Surpoids</term>
<term>Syndrome d'apnées obstructives du sommeil</term>
<term>Valeur prédictive des tests</term>
<term>Valeurs de référence</term>
<term>Éducation du patient comme sujet</term>
<term>Études de suivi</term>
<term>Évaluation des risques</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec><title>Study Objectives:</title>
<p>To determine if weight loss and/or changes in apnea-hypopnea index (AHI) improve sleep architecture in overweight/obese adults with type 2 diabetes (T2D) and obstructive sleep apnea (OSA).</p>
</sec>
<sec><title>Methods:</title>
<p>This was a randomized controlled trial including 264 overweight/obese adults with T2D and OSA. Participants were randomized to an intensive lifestyle intervention (ILI) or a diabetes and support education (DSE) control group. Measures included anthropometry, AHI, and sleep at baseline and year-1, year-2, and year-4 follow-ups.</p>
</sec>
<sec><title>Results:</title>
<p>Changes in sleep duration (total sleep time [TST]), continuity [wake after sleep onset (WASO)], and architecture stage 1, stage 2, slow wave sleep, and REM sleep) from baseline to year 1, 2, and 4 did not differ between ILI and DSE. Repeated-measure mixed-model analyses including data from baseline through year-4 for all participants demonstrated a significant positive association between AHI and stage 1 sleep (p < 0.001), and a significant negative association between AHI and stage 2 (p = 0.01) and REM sleep (p < 0.001), whereas changes in body weight had no relation to any sleep stages or TST. WASO had a significant positive association with change in body weight (p = 0.009).</p>
</sec>
<sec><title>Conclusions:</title>
<p>Compared to control, the ILI did not induce significant changes in sleep across the 4-year follow-up. In participants overall, reduced AHI in overweight/obese adults with T2D and OSA was associated with decreased stage 1, and increased stage 2 and REM sleep. These sleep architecture changes are more strongly related to reductions in AHI than body weight, whereas WASO may be more influenced by weight than AHI.</p>
</sec>
<sec><title>Clinical Trial Registration:</title>
<p>ClinicalTrials.gov identifier: NCT00194259</p>
</sec>
<sec><title>Citation:</title>
<p>Shechter A, St-Onge MP, Kuna ST, Zammit G, RoyChoudhury A, Newman AB, Millman RP, Reboussin DM, Wadden TA, Jakicic JM, Pi-Sunyer FX, Wing RR, Foster GD, Sleep AHEAD Research Group of the Look AHEAD Research Group. Sleep architecture following a weight loss intervention in overweight and obese patients with obstructive sleep apnea and type 2 diabetes: relationship to apnea-hypopnea index. <italic>J Clin Sleep Med</italic>
 2014;10(11):1205-1211.</p>
</sec>
</div>
</front>
</TEI>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Caroline du Nord</li>
<li>Pennsylvanie</li>
<li>Rhode Island</li>
<li>État de New York</li>
</region>
</list>
<tree><country name="États-Unis"><region name="État de New York"><name sortKey="Shechter, Ari" sort="Shechter, Ari" uniqKey="Shechter A" first="Ari" last="Shechter">Ari Shechter</name>
</region>
<name sortKey="Foster, Gary D" sort="Foster, Gary D" uniqKey="Foster G" first="Gary D." last="Foster">Gary D. Foster</name>
<name sortKey="Jakicic, John M" sort="Jakicic, John M" uniqKey="Jakicic J" first="John M." last="Jakicic">John M. Jakicic</name>
<name sortKey="Kuna, Samuel T" sort="Kuna, Samuel T" uniqKey="Kuna S" first="Samuel T." last="Kuna">Samuel T. Kuna</name>
<name sortKey="Kuna, Samuel T" sort="Kuna, Samuel T" uniqKey="Kuna S" first="Samuel T." last="Kuna">Samuel T. Kuna</name>
<name sortKey="Millman, Richard P" sort="Millman, Richard P" uniqKey="Millman R" first="Richard P." last="Millman">Richard P. Millman</name>
<name sortKey="Newman, Anne B" sort="Newman, Anne B" uniqKey="Newman A" first="Anne B." last="Newman">Anne B. Newman</name>
<name sortKey="Pi Sunyer, F Xavier" sort="Pi Sunyer, F Xavier" uniqKey="Pi Sunyer F" first="F. Xavier" last="Pi-Sunyer">F. Xavier Pi-Sunyer</name>
<name sortKey="Reboussin, David M" sort="Reboussin, David M" uniqKey="Reboussin D" first="David M." last="Reboussin">David M. Reboussin</name>
<name sortKey="Roychoudhury, Arindam" sort="Roychoudhury, Arindam" uniqKey="Roychoudhury A" first="Arindam" last="Roychoudhury">Arindam Roychoudhury</name>
<name sortKey="St Onge, Marie Pierre" sort="St Onge, Marie Pierre" uniqKey="St Onge M" first="Marie-Pierre" last="St-Onge">Marie-Pierre St-Onge</name>
<name sortKey="Wadden, Thomas A" sort="Wadden, Thomas A" uniqKey="Wadden T" first="Thomas A." last="Wadden">Thomas A. Wadden</name>
<name sortKey="Wing, Rena R" sort="Wing, Rena R" uniqKey="Wing R" first="Rena R." last="Wing">Rena R. Wing</name>
<name sortKey="Zammit, Gary" sort="Zammit, Gary" uniqKey="Zammit G" first="Gary" last="Zammit">Gary Zammit</name>
</country>
</tree>
</affiliations>
</record>

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Sleep Architecture Following a Weight Loss Intervention in Overweight and Obese Patients with Obstructive Sleep Apnea and Type 2 Diabetes: Relationship to Apnea-Hypopnea Index

Sleep Architecture Following a Weight Loss Intervention in Overweight and Obese Patients with Obstructive Sleep Apnea and Type 2 Diabetes: Relationship to Apnea-Hypopnea Index

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